Tester:
•FORCE: Adduct and extend through oblique plane (Press down & in, back to starting position).

Palpation/Function:
•If one is weak, treat as a whole
•The “Deltoids” function as a whole: Assists in every motion of the shoulder. Becomes shortened with supraspinatus in a depressed shoulder alignment. When short: Glenohumeral joint becomes abducted. To compensate, the shoulders become depressed and downwardly rotate drawing the arms into the thorax.
•Anterior Division: Assist in horizontal adduction, & Flex and internally rotate humerus.

Clavicle (Anterior/Lateral ½)
•Supine, palpate along anterior lateral ½ of clavicle into the outer to anterior surface of the acromion process.
•All the way over to where you feel the acromion curve around to the lateral surface. (Middle deltoid on lateral surface).

Deltoid Tuberosity (Anterior Surface)
•Palpate anterior surface of the deltoid tuberosity (on humerus)
•Come halfway down the humerus, find bump, and treat the anterior aspect.
•Have them push into your arm to help find the anterior surface of bump.

Palpation/Function:
•If one is weak, treat as a whole
•The “Deltoids” function as a whole: Assists in every motion of the shoulder. Becomes shortened with supraspinatus in a depressed shoulder alignment. When short: Glenohumeral joint becomes abducted. To compensate, the shoulders become depressed and downwardly rotate drawing the arms into the thorax.
•Anterior Fibers: Assist in horizontal adduction, & Flex and internally rotate humerus.

Clavicle (Anterior/Lateral ½)
•Supine, palpate along anterior lateral ½ of clavicle into the outer to anterior surface of the acromion process.
•All the way over to where you feel the acromion curve around to the lateral surface. (Middle deltoid on lateral surface).

Deltoid Tuberosity (Anterior Surface)
•Palpate anterior surface of the deltoid tuberosity (on humerus)
•Come halfway down the humerus, find bump, and treat the anterior aspect.
•Have them push into your arm to help find the anterior surface of bump

Palpation/Function:
•The “Middle” Deltoid is the most LATERAL of all the deltoids! It’s not the “medial deltoid!”
•If one tests weak, treat as a whole.
•The “Deltoids” function as a whole: Assists in every motion of the shoulder. Becomes shortened with supraspinatus in a depressed shoulder alignment.
• When short: Glenohumeral joint becomes abducted. To compensate, the shoulders become depressed and downwardly rotate drawing the arms into the thorax.

Acromion Process
•Supine, palpate along lateral aspect of shoulder across acromion.
•Lateral aspect of acromion process, palpate laterally
•Find spine of scapula, go to lateral angle of the posterior aspect of acromion, follow right across into the lateral aspect of the acromion.

Palpation/Function:
•The “Middle” Deltoid is the most LATERAL of all the deltoids! It’s not the “medial deltoid!”
•If one tests weak, treat as a whole.
•The “Deltoids” function as a whole: Assists in every motion of the shoulder. Becomes shortened with supraspinatus in a depressed shoulder alignment.
• When short: Glenohumeral joint becomes abducted. To compensate, the shoulders become depressed and downwardly rotate drawing the arms into the thorax.

Acromion Process
•Supine, palpate along lateral aspect of shoulder across acromion.
•Lateral aspect of acromion process, palpate laterally
•Find spine of scapula, go to lateral angle of the posterior aspect of acromion, follow right across into the lateral aspect of the acromion.

Palpation/Function:
•Treat as a whole if one is weak
•Posterior Fibers: Extends and externally rotates the humerus.
•Horizontally abducts humerus.
•Abduction with humerus internally rotated.
•Posterior Deltoid can become dominant as an external rotator if: Weakness of teres minor and Infraspinatus, combines pull of rotation and extension, creates anterior glide on the humeral head.

Spine of Scapula
•Supine, palpate along inferior, medial ½ of the spine of the scapula
•Find acromion, then find spine of scapula, come under spine, and work along the inferior aspect, curling up into the inferior aspect of the spine of the scapula.
•Curling into inferior aspect, treat entire inferior aspect of spine
•Pressure: up and in

Palpation/Function:
•Treat as a whole if one is weak.
•Posterior Fibers: Extends and externally rotates the humerus.
•Horizontally abducts humerus.
•Abduction with humerus internally rotated.
•Posterior Deltoid can become dominant as an external rotator if: Weakness of teres minor and Infraspinatus, combines pull of rotation and extension, creates anterior glide on the humeral head.

Spine of Scapula
•Supine, palpate along inferior, medial ½ of the spine of the scapula
•Find acromion, then find spine of scapula, come under spine, and work along the inferior aspect, curling up into the inferior aspect of the spine of the scapula.
•Curling into inferior aspect, treat entire inferior aspect of spine
•Pressure: up and in

Palpation/Function:
•Supraspinatus should be the last thing tested/treated. If the scapula is unstable and you test it, the scapula will downwardly rotate and you will impinge it which will cause a lot of pain.
•Initiates abduction of arm.
•Depresses and stabilizes the head of humerus inward toward glenoid.
•Slight flexion and internal rotation of humerus.
•Vulnerable to injury when the shoulder is depressed.

Supraspinatus Fossa
•Supine, palpate through upper trapezius into supraspinatus fossa.
•Use the spine of scapula as landmark, find spine, come anterior, and try to go down into the fossa. Have to use a lot of pressure because you have to go through the belly of supraspinatus to get to the bone. Try to fill in as much as you can until you hit the back of the clavicle.
•Treat the ENTIRE supraspinatus fossa.
•Anterior to spine of scapula

Greater Tubercle of Humerus
•Palpate under acromion onto greater tubercle.
•Anterior to acromion
•Find acromion process, there will be a split in the deltoid, internally rotate the arm, come right in between the split right on the head of the humerus just anterior to the acromion process.
•Find anterior/middle deltoid split, internally rotate the humerus, Greater tubercle of the humerus will come right to you.

Greater Tubercle of Humerus
•Palpate deep into posterior greater tubercle inferior to Infraspinatus.
•Pay attention to where head of humerus is, take them into full flexion, take their arm, find acromion drop off acromion onto head of humerus, head of humerus will fall out underneath the deltoid, find the head of the humerus, move it back and forth, the more flexion they are in, the more the head of the humerus is towards you. Come into the posterior aspect of the head of the humerus.
•Find tip of acromion, drop inferior and medial

Palpation/Function:
•Treat as a whole, the whole Infraspinatus fossa.
•Infraspinatus Function: Externally rotates humerus.
•Holds head of humerus in glenoid fossa (depressing the humeral head).
•If tight: may be a contributor to mid-scapular tension, and will contribute to excessive anterior glide of the humeral head contributing to impingement.
•Pain associated is usually in anterior shoulder.

Infraspinatus Fossa
•Prone, palpate upper ¼ of Infraspinatus fossa and along vertebral border.
•Fill in the entire Infraspinatus fossa
•Start out at root, work way over to posterior aspect laterally; work back and forth all the way down.

Palpation/Function:
•Treat as a whole, the whole Infraspinatus fossa.
•Infraspinatus Function: Externally rotates humerus.
•Holds head of humerus in glenoid fossa (depressing the humeral head).
•If tight: may be a contributor to mid-scapular tension, and will contribute to excessive anterior glide of the humeral head contributing to impingement.
•Pain associated is usually in anterior shoulder.

Infraspinatus Fossa
•Prone, palpate upper ¼ of Infraspinatus fossa and along vertebral border.
•Fill in the entire Infraspinatus fossa
•Start out at root, work way over to posterior aspect laterally; work back and forth all the way down.

Palpation/Function:
•Treat as a whole, the whole Infraspinatus fossa.
•Infraspinatus Function: Externally rotates humerus.
•Holds head of humerus in glenoid fossa (depressing the humeral head).
•If tight: may be a contributor to mid-scapular tension, and will contribute to excessive anterior glide of the humeral head contributing to impingement.
•Pain associated is usually in anterior shoulder.

Infraspinatus Fossa
•Prone, palpate upper ¼ of Infraspinatus fossa and along vertebral border.
•Fill in the entire Infraspinatus fossa
•Start out at root, work way over to posterior aspect laterally; work back and forth all the way down.

Palpation/Function:
•Treat as a whole, the whole Infraspinatus fossa.
•Infraspinatus Function: Externally rotates humerus.
•Holds head of humerus in glenoid fossa (depressing the humeral head).
•If tight: may be a contributor to mid-scapular tension, and will contribute to excessive anterior glide of the humeral head contributing to impingement.
•Pain associated is usually in anterior shoulder.

Infraspinatus Fossa
•Prone, palpate upper ¼ of Infraspinatus fossa and along vertebral border.
•Fill in the entire Infraspinatus fossa
•Start out at root, work way over to posterior aspect laterally; work back and forth all the way down.

Palpation/Function:
•Treat ALL if one is weak.
•Subscapularis Function: Internally rotates and adducts arm.
•Holds head of humerus in glenoid (depression).
•Depresses humerus in abduction against pull of deltoid.
•Pulls the head of humerus posteriorly, offsetting the muscles which pull into anterior/superior glide.
•Provide anterior gleno-humeral stability.
•Many times, overpowered by the larger internal rotators (lat & pec major).
•Most activity in 0-90º of abduction, as deltoid no longer pulls: it relaxes also
•If tight: will limit function of Supination which can impair function in the elbow, wrist and hand.

Scapula (Upper ¼ of Anterior Surface)
•Supine with scapula abducted, palpate upper ¼ of anterior surface of scapula (or have them lie on side, put arm on your shoulder, reach arm to the medial border of scapula & curl under all the way around).
•Can protract scapula, come anterior to scapula & lat. Come down and in onto the anterior surface of the scapula. Fill in as much as possible. Don’t come straight at armpit, come lower and angle up into the scapula, come in between lat and ribs and angle up and in to get the upper portion.
•Slide in & out of scapula, don’t just stay in there.

Lesser Tubercle of Humerus
•Palpate into upper humerus at lesser tubercle.
•Come into the humerus, under the deltoid and Lat
•Or can find Bicep tendon, come on medial aspect, through the deltoid and find the lesser tubercle.
•Have patient actively internally rotate.

Palpation/Function:
•Treat ALL if one is weak.
•Subscapularis Function: Internally rotates and adducts arm.
•Holds head of humerus in glenoid (depression).
•Depresses humerus in abduction against pull of deltoid.
•Pulls the head of humerus posteriorly, offsetting the muscles which pull into anterior/superior glide.
•Provide anterior gleno-humeral stability.
•Many times, overpowered by the larger internal rotators (lat & pec major).
•Most activity in 0-90º of abduction, as deltoid no longer pulls: it relaxes also
•If tight: will limit function of Supination which can impair function in the elbow, wrist and hand.

Scapula (Upper 2nd ¼ of Anterior Surface)
•Supine with scapula abducted, palpate upper 2nd ¼ of anterior surface of scapula (or have them lie on side, put arm on your shoulder, reach arm to the medial border of scapula & curl under all the way around).
•Can protract scapula, come anterior to scapula & lat. Come down and in onto the anterior surface of the scapula. Fill in as much as possible. Don’t come straight at armpit, come lower and angle up into the scapula, come in between lat and ribs and angle up and in to get the upper portion.
•Slide in & out of scapula, don’t just stay in there.

Lesser Tubercle of Humerus
•Palpate into upper humerus at lesser tubercle.
•Come into the humerus, under the deltoid and Lat
•Or can find Bicep tendon, come on medial aspect, through the deltoid and find the lesser tubercle.
•Have patient actively internally rotate.

Palpation/Function:
•Treat ALL if one is weak.
•Subscapularis Function: Internally rotates and adducts arm.
•Holds head of humerus in glenoid (depression).
•Depresses humerus in abduction against pull of deltoid.
•Pulls the head of humerus posteriorly, offsetting the muscles which pull into anterior/superior glide.
•Provide anterior gleno-humeral stability.
•Many times, overpowered by the larger internal rotators (lat & pec major).
•Most activity in 0-90º of abduction, as deltoid no longer pulls: it relaxes also
•If tight: will limit function of Supination which can impair function in the elbow, wrist and hand.

Scapula (Upper 3rd ¼ of Anterior Surface)
•Supine with scapula abducted, palpate upper 3rd ¼ of anterior surface of scapula (or have them lie on side, put arm on your shoulder, reach arm to the medial border of scapula & curl under all the way around).
•Can protract scapula, come anterior to scapula & lat. Come down and in onto the anterior surface of the scapula. Fill in as much as possible. Don’t come straight at armpit, come lower and angle up into the scapula, come in between lat and ribs and angle up and in to get the upper portion.
•Slide in & out of scapula, don’t just stay in there.

Lesser Tubercle of Humerus
•Palpate into upper humerus at lesser tubercle.
•Come into the humerus, under the deltoid and Lat
•Or can find Bicep tendon, come on medial aspect, through the deltoid and find the lesser tubercle.
•Have patient actively internally rotate.

Palpation/Function:
•Treat ALL if one is weak.
•Subscapularis Function: Internally rotates and adducts arm.
•Holds head of humerus in glenoid (depression).
•Depresses humerus in abduction against pull of deltoid.
•Pulls the head of humerus posteriorly, offsetting the muscles which pull into anterior/superior glide.
•Provide anterior gleno-humeral stability.
•Many times, overpowered by the larger internal rotators (lat & pec major).
•Most activity in 0-90º of abduction, as deltoid no longer pulls: it relaxes also
•If tight: will limit function of Supination which can impair function in the elbow, wrist and hand.

Scapula (¼ of Anterior Surface into Inferior Angle)
•Supine, with scapula abducted, palpate ¼ of anterior surface of scapula into inferior angle.
•Can protract scapula, come anterior to scapula & lat. Come down and in onto the anterior surface of the scapula. Fill in as much as possible. Don’t come straight at armpit, come lower and angle up into the scapula, come in between lat and ribs and angle up and in to get the upper portion.
•Slide in & out of scapula, don’t just stay in there.

Lesser Tubercle of Humerus
•Palpate into upper humerus at lesser tubercle.
•Come into the humerus, under the deltoid and Lat
•Or can find Bicep tendon, come on medial aspect, through the deltoid and find the lesser tubercle.
•Have patient actively internally rotate.

Biceps Tendon
•Supine, with elbow flexed, rotate arm to feel bicep tendon in groove, palpate superior aspect of tendon.
•Follow tendon of bicep up under the acromion process, as high as you can.
•Anterior and inferior to acromion process

Radial Tuberosity
•Have client actively flex elbow, follow tendon into attachment on radial tuberosity.
•Supinate and follow tendon to tuberosity on the radius. If they aren’t supinated you can’t get to bicep tendon. Have them relax and follow the tendon down onto the tuberosity of the radius.

Corocoid Process
•Supine, palpate into armpit following tendon into corocoid.

Radial Tuberosity
•Have client actively flex elbow, follow tendon into attachment on radial tuberosity.
•Supinate and follow tendon to tuberosity on the radius. If they aren’t supinated you can’t get to bicep tendon. Have them relax and follow the tendon down onto the tuberosity of the radius.

Corocoid Process
•Follow short head of bicep into attachment at corocoid process.
•Angle toward corocoid which is medial to the humerus and about at the bend of the clavicle, interior and anterior to the clavicle, follow split between deltoid and pec.
•Follow line of deltoid angling medially.

Humerus (Anterior Surface)
•Flex elbow to create slack on bicep
•Start medial to where deltoid is and lateral to where Coracobrachialis is.
•Palpate through bicep onto anterior surface of humerus
•Arm neutral, anterior lower half of humerus.
•Can pull bicep out of way to help get on lower anterior surface.
•Starting medial to where deltoid is.

Coronoid Process (Ulna)
•Contract bicep to follow tendon into Coronoid process of the ulna.
•Come right along lower anterior half, deeper than the bicep attachment.
•Keep them close to neutral while palpating.

Palpation/Function:
•When someone flexes their tricep the horseshoe area in the middle is the long head.
•Long Head Function: Extends and adducts humerus.
•With arm hanging: will pull humerus into acromion.
•Prevents it from being pulled out of socket.
•Opposes pull of lat and pec major from pulling humerus down and out of glenoid as they all adduct together.

Palpation:
•When someone flexes their tricep the big piece at the top easiest to notice (which sits laterally) is the lateral head.

Humerus & Lateral Tricep Belly
•Prone, palpate posterior lateral upper ½ of the humerus wrapping anterior to lateral belly.
•Follow deltoid, get upper lateral half on backside of humerus, pulling the deltoid out of the way getting on posterior humerus.
•Get superior/medial to deltoid, wrapping anterior to lateral belly. Pulling deltoid out of way to get to upper/lateral ½ of humerus.